The Ratio of Typical Clubbing in Pulled-Out Hairs as a Useful Marker in Predicting the Course of Alopecia Areata
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Analysis of hair microscopic morphology is a simple and less invasive method to differentiate alopecia areata (AA) from other alopecic diseases. However, there is limited information on the distribution of the microscopic characteristics. Objective: This study evaluated the microscopic morphological characteristics of pulled-out hair and their correlation with disease course in AA. Methods: Morphological characteristics of pulled-out hair were classified into 5 categories: the presence of typical clubbing, surface undulation, tapering, breakage, and depigmentation in proximal hair shaft. Clinical course of AA was investigated through assessment of Severity of Alopecia Tool (SALT) score (initial score, maximal score and difference of them [ΔSALT]). Results: Among 1,272 pulled-out hairs (n=179) obtained at initial visit, depigmentation (59.5%) was the most common, followed by loss of typical clubbing (57.2%) and surface undulation (55.2%). The percentage of loss of typical clubbing and proximal tapering was significantly higher in severe type of AA, younger age of onset and shorter disease duration. The ratio of typical clubbing (<50% vs. ≥50%) was associated with difference in maximal score and ΔSALT (p<0.05). Strong activity group (pulled-out hair ≥10, n=33) showed difference in clinical course (maximal score, ΔSALT) as well as distribution of microscopic features (loss of typical clubbing) compared with those in non-strong activity group. The ratio of typical clubbing significantly increased at follow-up than initially in strong activity group (p<0.05). Conclusion: Microscopic hair morphology, especially loss of typical clubbing and proximal tapering, could be useful tool to predict the course of AA.
Abstract
Background: Analysis of hair microscopic morphology is a simple and less invasive method to differentiate alopecia areata (AA) from other alopecic diseases. However, there is limited information on the distribution of the microscopic characteristics. Objective: This study evaluated the microscopic morphological characteristics of pulled-out hair and their correlation with disease course in AA. Methods: Morphological characteristics of pulled-out hair were classified into 5 categories: the presence of typical clubbing, surface undulation, tapering, breakage, and depigmentation in proximal hair shaft. Clinical course of AA was investigated through assessment of Severity of Alopecia Tool (SALT) score (initial score, maximal score and difference of them [ΔSALT]). Results: Among 1,272 pulled-out hairs (n=179) obtained at initial visit, depigmentation (59.5%) was the most common, followed by loss of typical clubbing (57.2%) and surface undulation (55.2%). The percentage of loss of typical clubbing and proximal tapering was significantly higher in severe type of AA, younger age of onset and shorter disease duration. The ratio of typical clubbing (<50% vs. ≥50%) was associated with difference in maximal score and ΔSALT (p<0.05). Strong activity group (pulled-out hair ≥10, n=33) showed difference in clinical course (maximal score, ΔSALT) as well as distribution of microscopic features (loss of typical clubbing) compared with those in non-strong activity group. The ratio of typical clubbing significantly increased at follow-up than initially in strong activity group (p<0.05). Conclusion: Microscopic hair morphology, especially loss of typical clubbing and proximal tapering, could be useful tool to predict the course of AA.
참고문헌 (12)
- Pratt CH, "Alopecia areata", Nat Rev Dis Primers, 3, pp.17011~ (2017)
- Dey A, "Targeting the Hippo pathway in cancer, fibrosis, wound healing and regenerative medicine", Nat Rev Drug Discov, 19, pp.480~494 (2020)
- Inui S, "Coudability hairs : a revisited sign of alopecia areata assessed by trichoscopy", Clin Exp Dermatol, 35, pp.361~365 (2010)
- Karashima T, "Morphological changes of the hair roots in alopecia areata : a scanning electron microscopic study", J Dermatol, 40, pp.1045~1048 (2013)
- Park SH, "Analysis of microscopic examination of pulled out hair in telogen effluvium patients", Ann Dermatol, 32, pp.141~145 (2020)
- Piérard GE, "EEMCO guidance for the assessment of hair shedding and alopecia", Skin Pharmacol Physiol, 17, pp.98~110 (2004)
- Whiting DA, "Histopathologic features of alopecia areata : a new look", Arch Dermatol, 139, pp.1555~1559 (2003)
- Eckert J, "The pathogenesis of alopecia areata", Br J Dermatol, 80, pp.203~210 (1968)
- Ihm CW, "Diagnostic value of exclamation mark hairs", Dermatology, 186, pp.99~102 (1993)
- Seol JE, "Three cases of radiation-induced temporary alopecia with hair microscopic examination : coudability hair might not be specific for alopecia areata", Int J Trichology, 10, pp.40~43 (2018)
- Tobin DJ, "Morphological analysis of hair follicles in alopecia areata", Microsc Res Tech, 38, pp.443~451 (1997)
- Messenger AG, "Alopecia areata : alterations in the hair growth cycle and correlation with the follicular pathology", Br J Dermatol, 114, pp.337~347 (1986)